Wednesday, April 19, 2006

Electronic lab results

My lab results came in electronically today. When I looked at my practice summary page this afternoon, there was a message saying that 147 labs were waiting for my review. The lab system sends the reports directly to the patient's chart. They also automatically flag abnormal results.

When I clicked the link to the lab results, all the results were there in two lists: abnormal (alphabetically by patient last name), and normal (same). The lab sent me all my results since March 23rd, which is why there were so many. To access each lab report, I clicked on the patient's name in the list, and the report came up, with abnormal tests highlighted. There is a section where you can make comments (I just put a "N" if the abnormality was irrelevant). You can print the whole report, or a subsection to give to the patient. You can also forward a note to your staff (for example, call the patient to let her know that the results were normal). When done, one click files the lab into the electronic chart.

Reviewing all these results and filing them electronically took me about 20 minutes (I'd already seen them before). My secretary would not have been happy if she had to pull 147 charts, put the results on the front, and then file the charts away again. I told my staff not to pull charts for lab results anymore, starting tomorrow. They will just give me the paper lab results unfiled; I want to make sure that there are no problems with the electronic results. If the two match, then the paper reports will be shredded. In a little while, I'll ask the lab not to send me paper reports anymore. The system checks for results every two hours; I'll have faster updates than through the current courier system.

I now have several patients who do not have any paper charts. Some are new patients; all new patients have electronic charts only. One new patient transferred from another practice with a bulky old paper chart; we scanned a couple of recent results and relevant consultations into the EMR. The rest went to the back room as a chart #2. Newborn babies do not have paper charts either: we scan the bit of paper we have, and the rest is electronic. The EMR generates percentiles for height, weight and head circumference automatically when I enter the numbers in, and the growth charts are also done automatically.

I'm getting more comfortable with doing some typing in the exam room. I'm a fairly good touch typist, so I can type while looking at and listening to patients.

I bought a docking station for the Tablet. I have a full keyboard and a mouse attached to the station; it also recharges the Tablet while it is docked. I leave it docked at lunch, and when I am finished seeing patients; I find that billing is much faster with the numeric keypad on a full keyboard.

My group is meeting on May 2nd. One of the things we will be discussing is remote access via VPN (see glossary); we don't have this yet, but it is supposed to happen sometimes in May.



Jean-Fran├žois Rancourt md said...

We decided to create a rule that put data of patient who have no file in our clinic in and "Orphan paitent"
So all data in this "orphan Patient" are see 1 or 2 type a week by secretary and she creates a file in our EMR with data on lab result. It's wonderful. next time lab result will be in his file.

Michelle Greiver said...

Thank you, Dr. Rancourt. From what you were telling me, several physicians in your group also work in Emerg and follow patients in hospital. You get electronic labs for these patients, but they do not have a file in your electronic office system. You have created a rule in the lab interface that automatically sends these results to an "orphan patient" file. Your staff regularly looks at the "orphan patient" file, and uses the demographic info (health #, address, DOB, phone) to make a new electronic file. The next time a lab comes in, the file is there, and the lab automatically gets filed.

This is a very ingenious solution to an unassigned patient problem.